MEDICARE: ROBERT M ZUKOSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	26071	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89928	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346223054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT M ZUKOSKI M.D.

Provider Business Mailing Address
First Line	:	904 N HOWE ST
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-5292
Fax Number	:	910-457-5409

Provider Business Practice Location Address
First Line	:	904 N HOWE ST
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-5292
Fax Number	:	910-457-5409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/08/2007

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